[Surgical technic of cesarean section. A preparatory cesarean section method primarily for saving the amnion].

A new technique of Caesarean delivery which makes adequate room for safe and gentle extraction of the infant and prevents injury to the foetus and the uterus is presented. The method consists of careful, layer by layer dissection in the lower uterine segment while keeping - whenever possible - the amniotic membranes intact. The opening can be made as large as needed. In a second step, the amniotic sac, now in full view, is carefully opened and the foetus safely extracted. In the ideal case, the lower part of the still intact amniotic sac containing the presenting part of the infant can be lifted out in front of the incision. There the membranes are opened and the foetus delivered. Bleeding is minimal and injury to the foetus and uterus is almost impossible. The wound can be closed with a single-layer suture, which promotes rapid healing and eliminates the danger of rupture during subsequent pregnancies. Further investigations will be necessary to prove whether this technique - lower cervical transverse Caesarean section with late amniotomy - will be worthy of becoming a standard procedure.